Table 1

The 10 Most Common Indications Listed in the AC for Echocardiography for Which TTE Were Ordered in an Academic Institution

Indication as Listed in the AC for EchocardiographyPercent of All Studies for Which the Indication Was Covered in the AC for Echocardiography (n = 1,385)
Number 1: Symptoms potentially caused by suspected cardiac etiology, including but not limited to dyspnea, shortness of breath, lightheadedness, syncope, TIA, cerebrovascular events28% (n = 384)
Number 2: Previous testing that is concerning for heart disease (i.e., chest X-ray, baseline scout images for stress echocardiogram, ECG, elevation of serum BNP)9% (n = 122)
Number 43: Re-evaluation of a patient with known heart failure (systolic or diastolic) to guide therapy in a patient with a change in clinical status6% (n = 81)
Number 10: Evaluation of known or suspected pulmonary hypertension including evaluation of right ventricular function and estimated pulmonary artery pressure5% (n = 70)
Number 17: Initial evaluation of murmur in patients for whom there is a reasonable suspicion of valvular or structural heart disease5% (n = 62)
Number 31: Initial evaluation of suspected infective endocarditis (native and/or prosthetic valve) with positive blood cultures or a new murmur4% (n = 54)
Number 11: Evaluation of hypotension or hemodynamic instability of uncertain or suspected cardiac etiology3% (n = 45)
Number 36: Evaluation of pericardial conditions including but not limited to pericardial mass, effusion, constrictive pericarditis, effusive-constrictive conditions, patients post-cardiac surgery, or suspected pericardial tamponade3% (n = 39)
Number 41: Initial evaluation of known or suspected heart failure (systolic or diastolic) in whom there is no change in clinical status3% (n = 38)
Number 42: Routine (yearly) re-evaluation of patients with heart failure (systolic or diastolic) in whom there is no change in clinical status3% (n = 37)

Results are reported as the percentage of all studies for which for which indication is covered in the AC for Echocardiography.

AC = Appropriateness Criteria; BNP = brain natriuretic peptide; ECG = electrocardiogram; TIA = transient ischemic attack.